Thursday, August 6, 2009

Dr appointment- the good the bad and the...ugly?

So yesterday I had my appointment that I had been dreading. There were some good parts and some bad parts. Good news is that I managed to make it through without crying or anything. I get really worked up when I am having too much done in my mouth, mostly from fear of pain after all I have been through, but I swore to myself I wasn't going to do that yesterday and I ended up doing really well. It took a while to get the teeth off. They had to pick at the "filler" they put in there, which is this thick cement-like stuff they stick around the posts I guess to keep it sealed or so things dont get in, I wasn't too sure about why it was in there. Anyway, the picking hurt because it jarred my jaw around too much (it's really thin, so jarring movements do give me pain) so he ended up using a drill on a slow speed to drill it away. Then he picked the cotton out that was also under there, and then he had to work on each individual implant to loosen the bridge of teeth off the implants.

It did take a long time and what was the most uncomfortable thing, I think, was having to keep my mouth open so wide for so long. I am sore today from it. Finally the teeth came off, and it wasnt as bad as I had expected. I kept apologizing if there was anything stuck under there...I do do my best to clean under there but it is really hard! The space is so tiny but still does collect food under it. Then, after the teeth came off, he had to screw these little metal things into each hole, I guess to keep them open. When you remove the denture, the extra tissue that is around the holes instantly close back over them and it becomes difficult to find them again. One of the holes he was unable to get anything back into it so he just had to stick something on top of it so he knew where it was. He then took an impression of my top teeth (which always makes me gag) and instead of taking one of the bottom from inside my mouth, he used the bottom of my denture to take the impression. Very smart, and that stuff is disgusting so I certainly wasnt complaining! He then poured it into a mold and made an image of the way my top and bottom teeth come together, as well as had the impression from the bottom so that at the lab they can now make the metal base to perfectly match the floor of my mouth.

We basically did 3 appointments in one looooong appointment. Then a couple hours later it was time to put the teeth back on. He went in and took the little metal things out of each hole, then stuck the denture on top. It was hard to get it aligned again the right way (the denture has little corresponding metal holes over where each implant goes to attach it to the implants) but he got it on there, he then packed around each implant area with more cottom, and screwed the whole denture back into place implant by implant. That took a while but it wasnt too painful. I did have to go home and sleep after it all, it was pretty emotionally exhaustive.

Phew! Sorry such a detailed explaination of the whole process, but I know some of you are going through this procedure or are waiting to, so you know what you have in store for you. I am sure I left stuff out, but it was a bit of a daze for me, mostly since I was so worried I just ket waiting to get some bad news.

A couple of other things happened as well. First, remember the "discharge" I said I was having? Only in the mornings, but on the left hand side it looks a little oogy sometimes until I clean it, then it doesnt happen the rest of the day. Well, Dr Wong said it did look a little puffy there but when he called in my other dr to look at it he said he thought it was probably that the denture had come a bit loose there and it was build up from food and such getting trapped in there. Honestly, Dr Wong said that if he was worried he'd be the first to tell me but he wasnt, and I trust him. So they went ahead and put the teeth back on. We had two complications from that point. One was that they were unable to get one of the implants to screw down onto the teeth again. I think that it was the one where the tissue collapsed over the hole again but am not too sure, but it was on the right side where I only already have one implant left since the other one came out (originally I had 5 implants placed). So I am down to only 3 implants being tightly secured. He said that he is just going to worry about that other one more when they put the final teeth on, as it was too much hassle since I am only going to have this bridge of teeth on for another, what, maybe 8 weeks or so.

The other complication was he said it appears that my whole bridge or lower area has "shifted." Meaning, it is no longer in the middle for some reason but he isnt too sure why it has shifted. That did worry me, I instantly thought of something being in my jaw again shifting my denture (ie, recurrence, I think we all worry about this constantly), but again Dr Wong said he was not concerned at all about it and that it would (hopefully) all work out in the end. Mostly it just means my bite is off a bit. They check your bite after the teeth are on, basically they take this little strip that looks like foil but isnt, and stick it in between your back teeth and tell you to bite and make a chewing gesture from side to side. Then they check the other side. It leaves an impression in the paper so he can see how my bite is, and I know on the left it is way less than on the right because of the shifting. But again if he says not to worry I'll try not to.

My final complication was after I had left already. I came home and ate some lunch (peanut butter and jelly sandwich). It felt great- no creaking or movement and I was able to chew really well. I was so pleased...until near then end when I felt it come loose. *sigh. So now my denture on the right feels SO unstable. I know it is related to the fact I only have the one implant secured on that side now because of that other one not being secured, but it is so disconcerting I cannot even tell you. When I move my jaw side to side, I hear the unsecured implant moving around in there. It bothers me. I know from this point on I will have to eat soft things until I can get this temporary bridge out and my new permanent one in. It's just frustrating, as it seems there is always always always something more to deal with. I am worried still a bit but not as much as I was before. I am still worried about that one area but am hoping now that the teeth are very tight over there it will work itself out. I got more of my medicated mouth rinse (Hibiclens) so will be using that faithfully still. Also, I am worried about the shifting. As with everything else I will just have to take it one day at a time.

Finally, this month it has been 4 years almost to the day that I had my first surgery. My son was very young, I think only about 6 weeks old, when they went in and took out my ameloblastoma. Its bittersweet looking back at all the time that has passed. I really have come so far in so many ways, and regressed so far in others. For every step I move ahead in this process I seem to take one back emotionally and mentally, but I am still struggling through it all. Praying seems to help a lot.

And I am out now for the day, this has been a long post! As usual, I will keep you posted, faithful readers.